Objective: This study aimed to investigate the correlation between postoperative noise exposure and anxiety/depression in patients with haemophilic osteoarthropathy undergoing hip/knee replacement. Methods: This retrospective study included 58 patients with haemophilic osteoarthropathy who underwent hip/knee replacement in four tertiary hospitals between 2020 and 2025. Data were collected from clinical records. Ward noise levels (daytime/nighttime) were measured on postoperative days 1–3 by using a sound level metre. Patients were divided into high-noise (≥45 dB, n = 30) and low-noise (<45 dB, n = 28) groups. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), sleep quality (Pittsburgh Sleep Quality Index, PSQI) and pain (Visual Analog Scale, VAS) were assessed. Pearson’s correlation and t-tests were used for statistical analysis. Results: The high-noise group had significantly higher mean noise levels (52.89 ± 6.24 dB vs. 44.57 ± 5.25 dB, P < 0.001). The SAS (51.41 ± 6.37 vs. 48.84 ± 5.23, P = 0.011) and SDS scores (54.16 ± 7.48 vs. 50.31 ± 5.25, P = 0.028) were higher in the high-noise group. Noise levels were positively correlated with anxiety (r = 0.682, P < 0.001) and depression (r = 0.659, P < 0.001). The high-noise group had poorer sleep quality (PSQI: 7.21 ± 2.35 vs. 5.19 ± 1.89, P < 0.001) and higher pain scores (VAS: 5.86 ± 1.54 vs. 4.23 ± 1.27, P < 0.001). Conclusion: Postoperative noise exposure is significantly associated with increased anxiety, depression, poor sleep and pain in patients with haemophiliac osteoarthropathy. Reducing ward noise may enhance their psychological well-being and postoperative recovery.

Background: The bidirectional relationship between physical health (PH) and depressive symptoms (DS) remains unclear. Methods: Data were extracted from the Health and Retirement Study in the United States. PH was measured with a composite of chronic diseases, functional limitations and difficulties in basic and instrumental activities of daily living, and DS with a modified Center for Epidemiological Studies of Depression. Latent growth curve models (LGCM) were employed to examine how the change in PH or DS affected their mutual trajectories in later life. In addition, multilevel models were utilized. Results: There were 6144 participants included, with an average age of 69.82 +/- 6.85 years at baseline, of whom 3686 (59.99 %) were women. PH scores increased from 5.65 in 2010 to 7.72 in 2018, while depression scores increased from 1.14 to 1.31. LGCM results showed that the initial levels of PH and DS were associated (beta = 0.558, P < .001), and the initial level of PH could predict the trajectory of DS (beta = 0.089, P < .001). Likewise, the initial level of DS was also related to initial PH (beta = -0.563, P < .001) but couldn't predict the trajectory of PH. Furthermore, the slopes of PH and DS were predicted bidirectionally by each other. Two-level logistic models further demonstrated the bidirectional association between PH and DS. Conclusion: There was a bidirectional association between physical health and depressive symptoms, which highlights the necessity of comprehensive health management for older adults with poor physical health or depression symptoms.

Background Depression is increasingly recognized as a worldwide serious, public health concern. A better understanding of depression is important for advancing its management and learning the difference between major depressive disorder (MDD) and dysthymia. Our aim is to conduct a concurrent analysis of the trends of both MDD and dysthymia in China. Methods The data on depression from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). To determine the average annual percent changes (AAPC) and relative risks (RRs), joinpoint regression and the age-period-cohort models were employed, respectively. Results The incidence number of MDD and dysthymia continuously increased in China from 1990 to 2019, however, the age-standardized rates (ASR) had a decreasing trend in both men and women. The results from joinpoint regression showed that a declining trend was presented in young people (< 50 years) but an increased trend in the elderly (≥ 50 years) both in men and women, during 1990–2019. Age is the most influential factor for MDD and dysthymia. Age RRs for MDD incidence had an overall increasing trend with age. Period RR in MDD presented a U-shaped pattern, while Cohort RRs presented an inverted U-shaped pattern. On the other hand, RRs in dysthymia for period and cohort effects had no statistical significance, only the age effect presented an inverted U-shaped pattern. Conclusions The disparities in trends observed between MDD and dysthymia during the period of 1990–2019 indicated the significance of distinguishing between these two disorders. The age, period and cohort effects all had a greater impact on MDD than on dysthymia, and age effects presented different influential patterns in these two. To alleviate the burden of depressive disorders in China, proactive measures need to be implemented, with particular attention to the elderly population.

Abstract Background Asthma and psychological-behavioral problems co-occur more frequently than would be expected based on chance. Several previous studies have shown that the association between childhood asthma and behavioral problems was unclear. Methods Three hundred and thirty seven 6-to-14-year children with asthma in a case group and 674 children without asthma in a control group, matched with age and sex in 1:2, was investigated from Gansu Provincial Maternal and Child Health Hospital. We obtained socio-demographic data on children and health-seeking caregivers. The Rutter’s Behaviour Scale for Children (Parents’ Scale) (RBSC-PS) was used to assess children’ behavioral problems. The quantitative relationship between childhood asthma and behavioral problems was evaluated with a conditional logistic regression. Results The overall prevalence of behavioral problems in the case group and the control group were 37.39% and 18.69% respectively, and the prevalence of type A, M, and N behavioral problems in the case group were all higher than those in the control group respectively (A:14.54% vs 10.68%; M: 6.53% vs 4.15%; N: 16.32% vs 3.86%). The results of multiple conditional logistic regression analysis showed that a statistically significant association was found between childhood asthma and behavior problems (adjusted odds ratio (aOR) = 1.46; 95% confidence interval (95%CI):1.16 ~ 1.83); The regression analysis for different types of behavioral problems showed that type A behavioral problem (aOR = 1.25;95%CI:0.91 ~ 1.71) or type M (aOR = 1.20; 95%CI:0.77, 1.88) were not associated with childhood asthma but type N behavioral problem had a statistically significant association with childhood asthma(aOR = 1.90;95%CI:1.40 ~ 2.57). Conclusion The type N behavioral problem was associated with childhood asthma, highlighting the importance of behavioral problem prevention for children with asthma in pediatric asthma clinics.

Background:The reported number of cases and deaths from common infectious diseases can change during major public health crises. We explored whether the coronavirus disease 2019 (COVID-19) had an impact on tuberculosis (TB) incidence and mortality in China based on routinely reported TB data.Methods:We used TB data used from the monthly national notifiable infectious disease reports in China from January 2015 to January 2023. Based on an interrupted time series (ITS) design, we applied Poisson and negative binomial regression models to assess the changes of reported TB incidence and mortality before and during the COVID-19 pandemic.Results:We found a significant and immediate decrease in the levels of both reported TB incidence (relative risk (RR) = 0.887; 95% confidence interval (CI) = 0.810-0.973) and mortality (RR = 0.448; 95% CI = 0.351-0.572) at the start of COVID-19 outbreak. During the pandemic, the slope of reported incidence decreased significantly (RR = 0.994; 95% CI = 0.989-0.999), while the slope of reported mortality increased sharply (RR = 1.032; 95% CI = 1.022-1.041) owing to an abrupt rise in reported mortality after January 2022.Conclusions:Both TB incidence and mortality decreased immediately at the start of the COVID-19 pandemic. Over a longer period, the COVID-19 pandemic had contributed to a sustained and more significant decrease in reported incidence, and a delayed but sharp increase in reported mortality.

OBJECTIVES:Multidrug-resistant tuberculosis (MDR-TB) has a high mortality and is always one of the major challenges in global TB prevention and control. Analyzing the factors that may impact the adverse outcomes of MDR-TB patients is helpful for improving the systematic management and optimizing the treatment strategies for MDR-TB patients. For follow-up data, the Cox proportional hazards regression model is an important multifactor analysis method. However, the method has significant limitations in its application, such as the fact that it is difficult to deal with the impacts of small sample sizes and other practical issues on the model. Therefore, Bayesian and conventional Cox regression models were both used in this study to analyze the influencing factors of death in MDR-TB patients during the anti-TB therapy, and compare the differences between these 2 methods in their application.METHODS:Data were obtained from 388 MDR-TB patients treated at Lanzhou Pulmonary Hospital from November 1, 2017 to March 31, 2021. Survival analysis was employed to analyze the death of MDR-TB patients during the therapy and its influencing factors. Conventional and Bayesian Cox regression models were established to estimate the hazard ratios (HR) and their 95% confidence interval (95% CI) for the factors affecting the death of MDR-TB patients. The reliability of parameter estimation in these 2 models was assessed by comparing the parameter standard deviation and 95% CI of each variable. The smaller parameter standard deviation and narrower 95% CI range indicated the more reliable parameter estimation.RESULTS:The median survival time (1st quartile, 3rd quartile) of the 388 MDR-TB patients included in the study was 10.18 (4.26, 18.13) months, with the longest survival time of 31.90 months. Among these patients, a total of 12 individuals died of MDR-TB and the mortality was 3.1%. The median survival time (1st quartile, 3rd quartile) for the deceased patients was 4.78(2.63, 6.93) months. The majority of deceased patients, accounting for 50%, experienced death within the first 5 months of anti-TB therapy, with the last mortality case occurring within the 13th month of therapy. The results of the conventional Cox regression model showed that the risk of death in MDR-TB patients with comorbidities was approximately 6.96 times higher than that of patients without complications (HR=6.96, 95% CI 2.00 to 24.24, P=0.002) and patients who received regular follow-up had a decrease in the risk of death by approximately 81% compared to those who did not receive regular follow-up (HR=0.19, 95% CI 0.05 to 0.77, P=0.020). In the results of Bayesian Cox regression model, the iterative history plot and Blue/Green/Red (BGR) plot for each parameter showed the good model convergence, and parameter estimation indicated that the risk of death in patients with a positive first sputum culture was lower than that of patients with a negative first sputum culture (HR=0.33, 95% CI 0.08 to 0.87). Additionally, compared to patients without complications, those with comorbidities had an approximately 6.80-fold increase in the risk of death (HR=7.80, 95% CI 1.90 to 21.91). Patients who received regular follow-up had a 90% reduction in the risk of death compared to those who did not receive regular follow-up (HR=0.10, 95% CI 0.01 to 0.30). The comparison between these 2 models showed that the parameter standard deviations and corresponding 95% CI ranges of other variables in the Bayesian Cox model were significantly smaller than those in the conventional model, except for parameter standard deviations of receiving regular follow-up (Bayesian model was 0.77; conventional model was 0.72) and pulmonary cavities (Bayesian model was 0.73; conventional model was 0.73).CONCLUSIONS:The first year of anti-TB therapy is a high-risk period for mortality in MDR-TB patients. Complications are the main risk factors of death in MDR-TB patients, while patients who received regular follow-up and had positive first sputum culture presented a lower risk of death. For data with a small sample size and low incidence of outcome, the Bayesian Cox regression model provides more reliable parameter estimation than the conventional Cox model.

目的 探索1 536例肺结核患者的耐多药状况及其影响因素.方法 数据资料来自2018-2020年结核病管理信息系统中登记管理的兰州市1 536例确诊肺结核患者.利用x 2检验和多因素logistic回归分析模型分析探索肺结核患者耐多药的影响因素.结果 1 536例肺结核患者中,耐药患者445例(29.0％),耐多药患者327例(21.3％).单因素分析结果显示,不同性别、年龄、民族、职业、户籍类型和登记分类间患者耐多药情况的差异均有统计学意义(均P＜0.05).多因素logistic回归分析模型分析结果显示,职业为农牧民及工人(OR=2.95,95％CI:1.32～6.59,P=0.008)、其他职业(OR=3.12,95％CI:1.41～6.88,P=0.005)、登记分类为复发(OR=6.16,95％CI:3.66～10.39,P＜0.001)、复治失败(OR=11.93,95％CI:4.61～30.88,P＜O.001)和初治失败(OR=14.10,95％CI:7.74～25.69,P＜0.001)的患者出现耐多药可能性较高;而兰州市户籍患者发生耐多药的可能性较低(OR=0.11,95％CI:0.08～0.16,P＜0.001).结论 兰州市肺结核患者耐多药率较高.农牧民及工人、其他职业、非兰州市户籍、复发、初治失败和复治失败是发生耐多药的主要危险因素.

Missing values often affect the data utilization in epidemiological survey. In this study, according to the cut-off point value of the medical diagnostic standard of fasting blood glucose for diabetes, we divide fasting blood glucose test data from the China Health and Nutrition Survey (CHNS) of Shandong province in 2009 into two classes: the normal and the abnormal. Accordingly, for missing fasting blood glucose values, we propose a two-stage prediction filling method with optimized support vector technologies competitively by particle swarm optimization (PSO) or grey wolf optimizer (GWO), which is to first predict the class of the missing data with support vector machine (SVM) in the first stage and then predict the missing value with support vector regression (SVR) within the predicted class in the second stage. In addition, we use the LIBSVM as a gold standard to train both SVM and SVR in different stages. For two kinds of competitive optimizers in stages, in the first stage GWO has the highest classification accuracy (91.1%), and in the second stage PSO has the smallest in-class mean absolute error (0.48). So, GWO-SVM-PSO-SVR is determined as the optimal model and a predicted value with it serves as a fill value. The comparison results of the models in empirical analysis also show that it outdoes any of the other filling models in terms of mean absolute error and mean absolute percentage error. In addition, the sensitivity analysis shows that it presents high tolerance as the sample size changes and has a good stability. Graphical abstract

BackgroundThe impact of depressive status (DS) on hypertension incidence is still controversial and has not been studied in Chinese middle-aged and elderly population. This study aimed to explore the relationship between DS and incident hypertension and analyze the joint effects of DS and body mass index (BMI) on hypertension incidence.MethodsWe conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationwide population-based study. In 2013, DS was identified using scores from the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) among eligible respondents from CHARLS, and hypertension occurrence was observed until 2018. The multiple Cox models were employed to calculate the associations between DS and hypertension incidence. In addition, we also computed the multiplicative interaction (MI) between DS and BMI of incident hypertension and assessed their additive interaction (AI) through relative excess risk due to interaction (RERI), attributable proportion (AP) or synthetic index (S). Positive AI was indicated by RERI > 0, AP > 0 or S > 1.ResultsOver the 5-year follow-up, depressive symptoms increased the risk of hypertension incidence by 19% (hazard ratio (HR) = 1.19, 95% confidence interval (CI): (1.01, 1.41)), while depression was associated with a 24% increased risk (HR = 1.24; 95% CI: (1.03, 1.50)). Significant MIs between DS and overweight or obesity were observed and almost all of AI indexes showed positive joint effects on incident hypertension, of which the depression-obesity combination had the largest joint effect (RERI = 4.47, 95%CI: (0.28, 8.66); AP = 0.67, 95%CI: (0.50, 0.85); S = 4.86,95%CI: (2.66, 8.86)).ConclusionDS could lead to hypertension and this impact was amplified when coexisting with higher BMI. It highlighted a need for precise interventions targeting weight management and depression treatment in the aging population to prevent hypertension.

[目的]了解兰州市HIV/AIDS报告病例相关特征的构成情况,分析艾滋病相关死亡的影响因素.[方法]通过收集兰州市2011-2019年HIV/AIDS报告病例信息,采用生存分析方法,构建贝叶斯Cox风险比例回归模型分析影响死亡的相关因素.[结果]本研究共选取2312例HIV/AIDS患者,其中艾滋病相关死亡45例.多因素回归结果显示,患者年龄越大,死亡风险越高;确诊时为AIDS患者的死亡风险是HIV感染者的13.91倍;与未接受CD4检测的患者相比,接受CD4检测的患者的死亡风险降低;进行抗病毒治疗者的死亡风险是未进行抗病毒治疗者的0.22倍.[结论]确诊时年龄、病程阶段、是否接受抗病毒治疗是兰州市HIV/AIDS患者艾滋病相关死亡的影响因素,因此要加强艾滋病相关人群健康教育,提倡早发现、早诊断、早治疗,扩大艾滋病检测与治疗的覆盖面,延长艾滋病患者的生存时间.

目的 探讨临床诊断儿童哮喘患者支气管舒张试验和肺功能指标变化的临床意义.方法 选择哮喘初次发作患儿646例,采用Easyone肺功能仪,在雾化吸入硫酸特布他林前后进行肺功能检测;比较用力肺活量(FVC)、呼气峰流速(PEF)、1秒用力肺活量(FEV1)、1秒率(FEV1/FVC)、用力呼气流速FEF25％、FEF50％及FEF25％～75％占预计值的百分比和改善率.结果 FVCChg、FEV1/FVC Chg、FEF25％～75％Chg及FEF50％Chg是诊断支气管舒张试验阳性的主要因素.FVC Chg(OR=8.202,95％CI:4.293～15.668)、FEV1/FVC Chg(OR=8.075,95％CI:4.188～15.567)及 FEF25％～75％Chg(OR=1.100,95％CI:1.012～1.196)均可增加支气管舒张试验阳性的风险,ROC曲线分析结果显示FVC Chg≥5.5％时,诊断为支气管舒张试验阳性的灵敏度69.0％,特异度83.5％.结论 支气管舒张试验阳性率,受多种因素影响,其中FVC Chg、FEV1/FVC Chg及FEF25％～75％Chg对舒张试验阳性判断有一定的诊断价值,其中以FVC Chg对支气管舒张试验阳性诊断价值最强.

目的 对广东省深圳市口岸入境人员病原谱的构成及特征进行分析,为口岸传染病的防控提供科学依据.方法 收集2015-2018年深圳市口岸入境人员基本信息、过境时间、体温、症状、病原检测结果等信息,通过描述性统计学方法,分析病原的分布特征以及不同症候群病原谱的构成情况.结果 共监测入境人员87 450人,病原检测阳性者20 174例,女性病原阳性率(23.69％)高于男性(22.73％).病原的检出存在明显季节性,检出病原以呼吸道病毒为主,其次为肠道病毒,流感病毒阳性率最高(20.81％),以B型和甲型H3N2为主.发热伴呼吸道症候群病原阳性率在各症候群中最高(30.87％).结论 口岸输入传染病的病原种类较多,病原阳性率较高,需加强口岸传染病的监测工作,为防止传染病的跨境传播提供保障.

Objective:To investigate the prevalence of hepatitis C virus (HCV) infection among hemodialysis (HD) patients in Lanzhou of Northwestern China, we interviewed 565 patients from five randomly sampled HD centers in Lanzhou with a structured questionnaire including sociodemographic characteristics, past medical history and HD-related factors.Methods:The testing results of anti-HCV and HCV-RNA in a recent HD from clinical information system were collected. A generalized estimated equation (GEE) logistic regression model was used to identify the determinants of HCV infection among HD patients.Results:The prevalence of anti-HCV or HCV-RNA infection among HD patients was 1.77% or 1.42% respectively. GEE model showed that history of kidney transplantation (HCV-RNA: OR=19.79, 95%CI: 12.69-30.85) could dramatically increase the risk of current HCV infection in dialysis patients. Compared with never using of blood products, using of blood products (anti-HCV: OR=2.38, 95%CI: 1.22-4.64; HCV-RNA: OR=15.23, 95%CI: 1.79-129.49) could increase the risk of HCV infection in dialysis patients. Moreover, with the increase of HD duration, the risk increased one time or so (anti-HCV: OR=1.83, 95%CI: 1.22-2.72; HCV-RNA: OR=2.00, 95%CI: 1.11-3.61). Furthermore, dialysis in multiple hospitals possessed more than three times risk of HCV infection (anti-HCV: OR=3.56, 95%CI: 3.11-4.08; HCV-RNA: OR=3.35, 95%CI: 1.88-5.96). Besides, HD patients having the history of acupuncture (HCV-RNA: OR=5.56; 95%CI: 1.16-26.67) or surgery (HCV-RNA: OR=6.39; 95%CI: 2.86-14.29) caused an about-six-times risk of current infections.Conclusion:It could be concluded that the prevalence of HCV infection was mild and using of blood products or kidney transplantation, long dialysis duration, dialysis in multiple hospitals, surgery or acupuncture treatment were some risk factors of HCV infection among HD patients in Lanzhou of Northwestern China.

目的 描述西北地区布鲁氏菌病(简称布病)的流行特征,探索其发病率与自然和社会因素的相关性.方法 收集全国2004-2015年布病监测数据、西北5省2004-2015年布病报告数据及自然和社会因素资料,描述布病的时间分布特征,采用主成分回归分析探索各因素对发病率的影响.结果 2004-2015年间西北5省布病发病率逐年升高,且整体高于全国水平.每年5-8月为发病高峰.牧业总产值、地区生产总值、牛肉牛奶产量与布病发病率呈正相关,牛期末数量与布病发病率呈负相关.结论 西北地区布病发生率较全国同期水平高,地区生产总值、牧业总产值、牛肉牛奶产量等社会因素对发病率有影响,春夏回暖季尽早防控,控制养殖规模,对于控制布病疫情具有重要意义.

为探索甘肃省气象因素与人间布鲁氏菌病发生之间的相关性,找出主要影响因素,以有效防控布鲁氏菌病,收集2004—2015年甘肃省月气象监测数据和布鲁氏菌病月发病数据,通过SPSS 20.0软件进行主成分分析,提取与布鲁氏菌病发生有关的主要气象因素.结果显示:2004—2015年,甘肃省布鲁氏菌病年发病数呈逐年增长趋势;在纳入分析的气象因素中,平均气温与和降水量均与布鲁氏菌病发生率呈正相关,且P<0.05.结果表明,平均气温和降水量是影响甘肃省布鲁氏菌病发生的主要气象因素,均对布鲁氏菌病发病率存在正向作用.因此,随时监测气候变化,及早预警,对控制布鲁氏菌病发生有一定的积极意义.

目的 了解甘肃省慢性病患者健康素养水平及其影响因素,为慢性病患者的健康宣教工作提供科学依据.方法 以甘肃省2017年健康素养监测数据库中5 416名慢性病患者为研究对象,采用x2检验和多因素logistic回归,探索慢性病患者健康素养的影响因素.结果 甘肃省慢性病患者的总体健康素养水平为6.91％.3个方面健康素养中,基本知识和理念素养具备率最高为15.18％,健康生活方式与行为素养具备率最低为8.42％;6类健康问题中,科学的健康观素养具备率最高为30.52％,慢性病防治素养具备率最低仅为10.32％;多因素logistic回归分析提示:是否慢性病"共病"(是:OR=0.716,95％CI:0.516～0.993)、民族(汉族:OR=2.794,95％CI:1.652～4.725)、文化程度(高中/中专:OR =2.547,95％CI:1.648～3.936;大专及以上:OR = 2.039,95％CI:1.478～2.794)、自评健康状况(好:OR = 1.477,95％CI:1.057～2.065)和职业(事业单位职工:OR = 3.477,95％CI:2.226～5.432;学生:OR = 3.267,95％CI:1.203～8.871;工人:OR = 1.718,95％CI:1.064～2.774)是慢性病患者健康素养的影响因素.结论 甘肃省慢性病患者健康素养水平仍较低,尤其是"共病"患者、少数民族居民、初中及以下学历人群、自评健康差者和农民,他们是健康教育与促进的工作重点.

为了解兰州市七里河区居民布鲁氏菌病(简称布病)知识掌握与防护行为情况,2020年设计布病知信行调查问卷,对该地区91名职业暴露人群进行普查,并随机抽取218名非牲畜接触行业从业人员进行调查.结果显示:309人中听说过布病者占60.19％(186/309),布病听说率在不同民族、年龄、是否职业暴露人群有统计学差异(P<0.01),汉族、30岁以上的居民、养殖人员的听说率较高;布病患病率为2.59％(8/309),其中职业暴露人群患病率高于非牲畜接触行业从业人员(P<0.001);布病知识知晓情况整体较差,且不同性别、职业人群知晓程度有差异(P<0.05),知晓率最低条目"布病可经消化道传播"在养殖人员和从业人员间有统计学差异(P<0.01);养殖人群防护行为整体较好,但人畜分开饮水、按时接种布病疫苗的防护率低.结果表明:七里河区居民布病知识知晓度整体不高,养殖人员职业防护行为整体较好但存在防护短板,具有较高的暴露风险.因此,防疫部门应加强布病知识宣教,针对不同人群开展针对性行为指导,从而提高居民的布病防护意识.

Background: The aim of this study was to reveal the correlations between serum concentration of Clara cell secretory protein (CC16) and clinical parameters of stable chronic obstructive pulmonary disease (COPD). Patients and Methods: Serum concentration of CC16 was determined by enzyme-linked immunosorbent assay (ELISA). The correlations between serum concentration of CC16 and clinical parameters was performed by linear correlation analysis and multiple linear regression analysis. The sensitivity and specificity of serum CC16 for differential diagnosis of COPD were determined by receiver operator characteristic curve (ROC). Results: The serum concentration of CC16 was down-regulated in stable COPD patients compared with healthy control group (p < 0.05). The decreased serum CC16 was negatively related to smoking (p < 0.05), GOLD grading (p < 0.005), mMRC score (p < 0.05) and medical history (p < 0.05) of patients, but positively correlated with pulmonary function (p < 0.05). The smoking, FEV1/FVC values, COPD grading and mMRC scores all affected the concentration of CC16 (p < 0.05). The decreased CC16 was an independent risk factor in the process of deterioration of lung function. The sensitivity and specificity of serum CC16 for identifying COPD reached to 65.3% and 75%. Conclusion: Decreased serum concentration of CC16 correlated with the disease progression of COPD, suggesting that it can be used as an indicator contributing to the diagnosis and assessment of COPD.

目的 采用加权秩和比(WRSR)法对兰州市血液透析门诊丙型肝炎病毒(HCV)传播风险进行评估.方法 根据WRSR法选取5项指标,利用变异系数确定指标权重,按风险高低划分成高、中、低三个等级,对兰州市17所医院血液透析门诊进行HCV传播风险评估.结果 WRSR值与概率单位存在高度相关性(r=0.981,线性回归方程为:WRSR=0.164×Y-0.311).分档结果显示Y16和Y17两所医院血液透析门诊感染HCV为低风险,Y1医院血液透析门诊HCV感染有高风险,其他14所医院为中等风险.结论 兰州市医院血液透析门诊中HCV传播风险等级差异很大,大部分处于中、低风险水平.血液透析门诊应根据自身薄弱环节采取针对性的措施,加强HCV传播的防控工作.

目的 探讨兰州市血液透析患者乙型肝炎病毒(Hepatitis B virus,HBV)感染的危险因素.方法 对兰州市五家医院血透门诊血透患者问卷调查,收集患者一般人口学资料、既往病史、血液透析过程相关因素、HBV病毒感染检测资料,对数据进行单因素及广义估计方程模型分析.结果 共调查565例血液透析患者,其中HBV阳性31例,感染率为5.49％.广义估计方程模型分析显示使用血液制品(1 998年以前OR=8.077,95％ CI:3.469 ～ 18.803;1998年以后OR=2.678,95％ CI:1.719 ～4.170)、输血(1 998年以前OR=5.344,95％ CI:2.212 ～ 12.910)、透析龄/月(OR=1.008,95％ CI:1.002～1.014)、创伤性美容(OR=1.954,95％ CI:1.015～3.766)、文化程度低(OR =3.564,95％ CI:1.881 ～6.753)使透析患者感染HBV的风险提高;年龄＞40岁(OR=0.214,95％ CI:0.064 ～0.712)的血液透析患者相对于25岁以下患者乙型肝炎病毒表面抗原(hepatitis B surface antigen,HBsAg)阳性率较低.结论 使用血液制品、输血、透析龄越长、创伤性美容和文化程度低能增加血透患者感染HBV风险,在临床中应格外重视血液和血液制品管理和使用,规范透析操作,加强乙型肝炎防治宣传工作.